Cognitive frailty in older adults: examining the impact of frailty criteria on neuropsychological profile, functional outcomes, activity levels, and quality of life.

Autor: Chew J; Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore. justin_chew@ttsh.com.sg.; Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore. justin_chew@ttsh.com.sg., Tan CH; Department of Psychology, Nanyang Technological University, Singapore, Singapore.; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore., Chew P; Department of Psychological Services, Tan Tock Seng Hospital, Singapore, Singapore., Ng KP; Department of Neurology, National Neuroscience Institute, Singapore, Singapore.; Duke-NUS Medical School, Singapore, Singapore., Ali N; Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore.; Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore., Lim WS; Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore.; Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore.; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Jazyk: angličtina
Zdroj: European geriatric medicine [Eur Geriatr Med] 2024 Dec; Vol. 15 (6), pp. 1803-1815. Date of Electronic Publication: 2024 Sep 17.
DOI: 10.1007/s41999-024-01040-8
Abstrakt: Purpose: Cognitive frailty (CF) is the co-existence of cognitive impairment and physical frailty without dementia, conferring greater risks of adverse clinical outcomes compared to either condition alone. However, the impact of physical frailty components on cognitive performance remains unclear. This study aims to evaluate CF by determining the neuropsychological profiles, functional outcomes, activity levels, and quality of life across the Fried Frailty Phenotype (FFP) and its components.
Methods: Cross-sectional study involving 120 community-dwelling older adults without dementia, but with subjective cognitive complaints (SCC, defined as AD8 ≥ 1). Participants were stratified into three groups to assess CF: SCC-Robust, SCC-Prefrail, and SCC-Frail, and further categorized by individual FFP components. Cognitive performance was assessed by comparing neuropsychological test battery (NTB) Z-scores between CF and non-CF groups with Cohen's d for effect sizes. We performed linear regression to examine the relationships between both groups with NTB scores, Instrumental Activities of Daily Living (IADL), Frenchay Activities Index (FAI), and quality of life scores.
Results: NTB scores showed no differences between individuals with CF when classified according to FFP criteria. Individuals with SCC-slow gait speed exhibited reduced processing speed (d = 0.62) and memory (d = 0.61); SCC-fatigue was associated with decreased working memory (d = 0.55). Regression analyses, adjusted for demographic and clinical variables, identified significant associations: slow gait speed with logical memory (- 0.42; 95% CI - 0.79 to - 0.038]) and symbol search (- 0.28; 95% CI - 0.56 to - 0.006]); fatigue with digit span backwards (- 0.66; 95% CI - 1.19 to - 0.14) and color trails 2 (- 0.67; 95% CI, - 1.15 to - 0.20). SCC-slow gait speed and SCC-fatigue were associated with reduced quality of life scores, but not with IADL and FAI scores.
Conclusion: Specific frailty components, notably slow gait speed and fatigue, influence cognitive function and quality of life. Our findings provide greater insights into characterizing CF. Further longitudinal studies are required to determine the cognitive and functional trajectories of CF.
Competing Interests: Declarations. Conflict of interest: The authors have no conflicts of interest to disclose.
(© 2024. The Author(s), under exclusive licence to European Geriatric Medicine Society.)
Databáze: MEDLINE
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